摘要：Objective To analyze the incidence and survival rates of primary liver cancer(PLC)among residents in Yangpu district of Shanghai.Methods A total of 9 730 736 permanent residents(male 4 996 390 and female 4 734 346)of Yangpu district in Shanghai were recruited in the study between year 2002 and 2010; among whom 2726 PLC cases were diagnosed and 2427 death cases were certified.The incidence and mortality of PLC were calculated under the analysis of the new PLC cases and death cases between year 2002 and 2010.The rates were standardized by the demographic composition developed in the Fifth Nationwide Census in year 2000,in order to analyze the survival condition of PLC patients and explore the prognosis of surgical excision treatment.Results Among the new PLC cases between year 2002 and 2010,1966 cases were male,whose average age of onset was 59.81 ; while 760 cases were female,whose average age of onset was 68.93.The crude incidence rate was 39.35/100 000 in male,which was higher than it in female,as 16.05/100 000.The difference showed statistical significance(U =7.32,P ＜0.01).The standardized incidence rates were 21.98/100 000 and 6.96/100 000 in male and female,respectively.The difference showed statistical significance(U =221.76,P ＜ 0.01).There were 2427 PLC death cases in total,including 1734 male death cases and 693 female death cases.The crude mortality rate was 34.71/100 000 in male and 14.64/100 000 in female,whose difference were statistically significant(U =6.68,P ＜0.01).The standardized mortality rate was 19.16/100 000 in male and 6.06/100 000 in female,whose difference were statistically significant(U=207.18,P ＜ 0.01).The incidence and mortality rates both increased apparently since males aging over 35 and females over 45.The 1-5 year survival rates of PLC patients were 33.95％,23.11％,17.04％,14.42％ and 12.29％,respectively.In the surgical excision treatment group(321 cases),the 1-5 year survival rates were separately 66.78％,52.87％,41.88％,33.57％ and 32.64％ ; while in the non-surgical treatment group(2405 cases),the 1-5 year survival rates were separately 29.04％,18.58％,13.30％,11.16％ and 9.01％.The differences in 1-5 year survival rates between surgical and non-surgical groups all showed statistical significance(U =12.78,10.52,8.28,5.56 and 5.12,respectively,P ＜ 0.01).Conclusion The incidence of PLC was close to its mortality in Yangpu district of Shanghai.The male incidence and mortality rates were significantly higher than female corresponding rates.The surgical excision treatment could improve the prognosis of PLC.%目的 分析上海市楊浦區原發性肝癌(PLC)患者的發病和生存情況.方法 以2002-2010年上海市楊浦區常住戶籍居民為研究對象,共9 730 736人,其中男性4 996 390人,女性4 734 346人；PLC發病2726例,死亡2427例.對2002-2010年PLC新發患者和死亡患者進行分析,計算PLC發病率及死亡率,并用2000年全國第5次人口普查的標準人口年齡構成進行標化,分析患者生存情況,同時探索手術切除治療對PLC預后的影響.結果 2002-2010年PLC新發患者中,包括男性1966例,女性760例.男女平均發病年齡分別為59.81歲和68.93歲.男性粗發病率為39.35/10萬,高于女性的16.05/10萬,差異有統計學意義(U=7.32,P＜0.01)；男性標化發病率為21.98/10萬,高于女性的6.96/10萬,差異有統計學意義(U=221.76,P＜0.01).PLC患者死亡2427例,包括男性1734例,女性693例；PLC粗死亡率男性為34.71/10萬,高于女性的14.64/10萬,差異有統計學意義(U=6.68,P＜0.01)；標化死亡率男性為19.16/10萬,高于女性的6.06/10萬,差異有統計學意義(U=207.18,P＜0.01).男性在35歲以后,女性45歲以后發病率和死亡率均升高.PLC患者1～5年生存率分別為33.95％、23.11％、17.04％、14.42％和12.29％.手術切除組321例,1～5年生存率分別為66.78％、52.87％、41.88％、33.57％和32.64％;非手術組2405例,1～5年生存率分別為29.04％、18.58％、13.30％、11.16％和9.01％,手術切除組均高于非手術組,差異均有統計學意義(U值分別為12.78、10.52、8.28、5.56、5.12,P值均＜0.01).結論 上海市楊浦區PLC的發病率與死亡率接近,男性發病率和死亡率均高于女性,手術治療可改善原發性肝癌的預后.
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